Radiotherapy is a form of treatment for tumours and other lesions which involves directing a beam of ionising radiation toward the lesion. The radiation harms the tumour tissue and causes its reduction or elimination. However, the radiation is also harmful to healthy tissue around the lesion; although healthy tissue is slightly less susceptible to the effects of ionising radiation, measures are taken to limit the exposure of healthy tissue to the extent possible.
One such measure is to direct the beam toward the lesion from a number of radial directions by mounting the radiation source in a treatment head which is movable with respect to the lesion, such as by being mounted on a rotatable gantry. Thus, the lesion (or part of it) remains in the beam at substantially all times whereas each individual section of healthy tissue around the beam is only exposed to the beam briefly. In this way, the dose delivered to the lesion can be a multiple of the dose delivered to healthy tissue remote from the lesion.
Another measure is to collimate the beam so as to limit its lateral extent and avoid the unnecessary irradiation of healthy tissue. Modern collimators for radiotherapy devices are known as “multi-leaf collimators” and comprise an array of adjacent tungsten leaves, each of which is narrow so as to provide a high resolution but deep (in the direction of the beam) so as to provide an effective attenuation of the beam. Each leaf is moveable into and out of the beam, largely independently of those around it, so that the tips of the individual leaves can define a variable shape as required. Two such “banks” of leaves will usually be provided, on opposing sides of the beam aperture, thereby allowing a field to be defined within that aperture, of substantially any shape. An example of a multi-leaf collimator (MLC) is disclosed in our earlier application published as EP-A-0314214.
There are however limits to the attenuation that can be provided by a multi-leaf collimator. In particular, rules govern the minimum distance between opposing leaves so as to prevent the leaves from jamming or being damaged. Further, whilst it may be permissible for one leaf to be extended so that its tip touches or very closely approaches the tip of the exactly opposite leaf, those tips are usually rounded so as to provide a small penumbra at the patient, and therefore there will be leakage from the gap between them. For these reasons, there is usually a “block collimator” in series with the multi-leaf collimator, in the form of a substantial block of tungsten that can be extended or retracted in a direction transverse to the movement direction of the leaves. Thus, it can cover a region outside the defined field where the entire width of the aperture needs to be covered. Typically, there will be a pair of block collimators, one either side of the beam, the or each block collimator being substantially square or rectangular, as seen in the direction of the radiation beam to be collimated.
The block does impose a substantial weight penalty. The collimators are usually accommodated in the radiation source, which is to be rotated around the patient in order to allow the beam to be directed toward the lesion from a variety of radial directions. Thus, a reduction in this weight would be beneficial. Our earlier application EP2153448A1 described one such way of doing so.
The collimator blocks are required to be of the order of 8 cm thick solid tungsten material. This imposes a significant weight burden. Correspondingly, the mechanism required to move a significantly greater mass of collimator block will be correspondingly heavier itself. Both of these increase the overall mass of the treatment head, which in turn causes the structure of the radiotherapy apparatus to deflect more, resulting in further complications for the compensating control systems. It should be borne in mind that most clinical accelerators place the treatment head at the end of a long arm which is mounted on a rotatable support so that the treatment head can be rotated around the patient. Additional mass at the end of that arm causes the arm to deform in a direction which will vary (relative to the treatment head) as the treatment head traverses in an arc around the patient. The present invention therefore seeks to provide an arrangement which is able to offer the necessary blocking of the radiation beam, whilst reducing mass over conventional arrangements.